Keeping People Informed During Public Health Crises

During public health emergencies, it is especially critical that only designated staff interact with the media, including social media. Otherwise, contradictory or confusing information could be generated that erodes the public’s confidence in the health department and hampers the effectiveness of future messaging.

• In PCHD, the primary spokespeople are the health department director and the public information officer, who issues communications via email, social media, and other channels.

Developing core messages ahead of time sets a time-saving foundation for initial communications and help ensure messaging consistency when a public health event occurs.

• PCHD has a series of message maps for potential disasters that are pre-populated to address common questions, concerns, and key messages for different stakeholders.

A risk communication plan includes coordinating contact lists, media staging points, and equipment to use when routine communication systems are down (e.g., short-wave radios and satellite phones).

• PCHD uses the Center for Disease Control and Prevention’s (CDC’s) Crisis and Emergency Risk Communication (CERC) Manual to guide the structure and processes of its risk communication.
  

To ensure that all populations receive needed information, health departments need to do more than print their risk communication messages in other languages; how people perceive risk can vary greatly among cultures and circumstances. Moreover, communities that mistrust government may not follow government recommendations. Effective risk communication strategies include using foreign language-specific media outlets to communicate with people who have limited English proficiency and sending emergency messages to community organizations, community opinion leaders, and other trusted messengers.

• Additional lessons from Vermont: during the COVID-19 pandemic, the Vermont Department of Health (VT DOH) held focus groups with different populations, including non-native English speakers, farm associations, agencies serving migrant farmworkers, and the state agricultural agency. Based on the information gleaned, VT DOH co-created new messages and strategies with the community to reflect the context of the populations of focus.
  • People from other countries and refugees were more concerned about losing their jobs or their ability to buy food for their family than coming down with COVID; therefore, initial messaging about staying home did not resonate with them. VT DOH co-developed messages with trusted leaders about how best to protect all members of the family, recognizing that many homes include multiple generations and multiple families. The focus was on protecting the most vulnerable household members, i.e., the oldest and youngest generations, so this meant messaging for those leaving the house for work on how best to protect themselves and not bring home the virus.
  • For farmworkers living in congregate housing, VT DOH worked closely with the farmers, the workers, the agriculture agency, the extension service (with relationships in outreach and education), and local clinics to provide mobile education, testing, and vaccination services.
  • In rural areas, the health department relied on informal channels of communication. Town clerks, librarians, and other community partners passed along key messages and distributed hand sanitizer, masks, and test kits to community members.

Because public health emergencies can affect more than one jurisdiction, neighboring health departments must coordinate. It’s important to establish regional guidelines for communicating about urgent and emergent situations.

• PCHD participates in the Mid-America Regional Council (MARC), which comprises health departments in and around Kansas City, Missouri. MARC has guidelines for regional releases based on the severity and urgency of the public health emergency.

The public looks to government authorities in an emergency, and people will fill in the blanks, sometimes incorrectly, if information is not forthcoming.

• When a hazard is detected, PCHD immediately releases a general message and then gets to work crafting more detailed messages. For example, an initial message about a chemical spill might include information about the location of the spill, type of chemical involved, immediate health department activities, symptoms of exposure, actions individuals should take; and note that the health department will issue additional information as it becomes available.

With guidance from health department subject matter experts and external partners, additional messages should include more detailed information as it becomes available. For example, with a chemical spill, this might include information about the precise extent of the hazard, designated sites for medical care, and when it is anticipated that evacuation orders will be ended.

All health department staff may field questions from community members during public health emergencies. In this way, all staff are an extension of the public information officer. It is important that all staff have up to date information to ensure accurate and consistent messaging through informal channels.

While the public is the target of many communications, key people in various agencies and organizations are critically positioned to receive and act on emergency communications. At the top of the list is emergency management services, given that they usually have a role in public health emergencies. Even though emergency management services staff typically have a close relationship with the health department’s emergency preparedness coordinator, it is mutually beneficial for the public information officer (or lead communications staff, if it is someone other than the emergency preparedness coordinator) to work closely with emergency services staff as well. First responders often have a critical role to play as well. School districts, hospitals, and community-based organizations support emergency response in many ways, including providing physical space, clinical care, and connections to the community.

• The PCHD PIO spends time in the community getting to know key people who participate in emergency response and is very open to feedback about how to enhance the health department’s risk communication strategy.

First responders and hospitals engage in various emergency drills and exercises. Fully participating in these opportunities sometimes generates updates to the risk communication strategy and also helps maintain critical relationships.

The key to maintaining a strong and effective risk communication strategy is performing regular updates and focusing on relationships with critical partners and stakeholders.